A Medic’s Train of Thought

One of our Street Medics was on the Amtrak train that derailed in Montana on Saturday. Read on to see how she was able to use her skills to help at the scene. Warning: some of it is graphic.

I walked away from a literal train wreck. While there are dozens of news stories about the event out there, my story is from the viewpoint of a first responder. Please note that some of the descriptions may be graphic.

I was a medic until the first ambulance got there, Lurko was helping to get people out of the cars, and later we both were helping a passenger who only spoke Spanish. There were about 170 passengers and 13 crew members, and lots of local EMS and fire crew who came to help. The New York Times reported 50+ people injured. I’m not sure the number was quite that high…probably about 15 people were taken away in ambulances, but then I saw a few people later who didn’t think they were hurt at the time, or didn’t think their injuries warranted an ambulance ride. So maybe when all is said and done it will be that many injured, but thankfully the majority of us walked away.

When it happened, we were riding coach on the upper deck of the middle car. The dining car was in front of us and the observation car was behind us. We had been hanging out in the observation car earlier that morning, but Lurko made us go back to our seats because I had my work laptop with me and I wasn’t getting any work done. So we were not in that car when it tipped over, and that is very likely what saved us.

We were tracking where we were on Google Maps, and we had just passed Joplin, A CDP in Montana, when our car started swaying back and forth. Lurko said, “We’re derailing,” which was the conclusion I was also coming to. I grabbed the nearest thing, which was Lurko, and stared at the window to see if we were going to fall over. Our side leaned over but didn’t fall, and once everything stopped moving we grabbed our stuff and checked to see if everyone on our car was okay. There were only about 12-15 people in coach and everyone was fine. We got to the bottom floor but the door was stuck, but Lurko and two Marines got the door open. We were helped outside by an off-duty EMT who had been on his way to a wedding and saw the train derail, and rushed over to help. Then he called for help and said “Send everyone!” And by the end of this story, literally every emergency service from 6 counties showed up. 

But before the first ambulances arrived, we were busy trying to get everyone out of the cars and assessing who was hurt. Somehow I found an Amtrak first aid kit, and I was called to the other side of the observation car to look at two people who were hurt. The first patient, who was worse off of the two, was lying on their back and bleeding from a head wound. Another person was there, holding the patient’s hand and trying to keep them calm. The patient was conscious and breathing, so I thought the first thing I should do was stop the bleeding. But I wasn’t sure where the bleeding was coming from, so I gently rinsed the area and saw it was a pretty long gash, and deep, like maybe their skull was cracked. Applying pressure to that kind of head wound is not the best idea for that area, but luckily, they weren’t bleeding anymore (which in hindsight I think might have been due to shock). The ambulance showed up pretty quickly after that so I directed the crews to both injuries and they were whisked away.

I hope the patient is ok. They had the worst of the injuries I saw… other people had broken bones and scrapes but almost all of them could walk. We saw one body under the observation car, and later a person frantically searching for their missing fiancé. We were all pretty sure the body was the fiancé, but we helped them by getting a description and the missing person’s name, and getting the word out to the other passengers. The fiancé was not found, and eventually someone did tell them about the body (it was the fiancé after all) and they started screaming and crying until an ambulance took them, too. Eventually we learned two more bodies were found under the observation car. We talked with a burner (who recognized the BM logo on Lurko’s shirt) who we’ll call “Gage,” who had been on that car. He said he was on the upper floor, and when it fell over he grabbed onto one of the seats that was bolted to the floor, and that’s what kept him from falling out the window when it broke. Then once everything stopped moving he was able to escape through the broken window, which was hanging over the side of the tracks.

So more EMS folks showed up, all the passengers were herded to the side of the train, and gradually the school buses and shuttle transports came to take people to the nearest shelter…which at first was the Chester Senior Center. However, they soon realized it wasn’t big enough to hold all of us, so the rest of us went to the Chester-Joplin-Inverness high school. Lurko, the two Marines, and I were the last passengers to leave because we wanted to make sure everyone else was okay, and then we left on the last shuttle with 9 train crew members. One of them was the worker from the snack bar on the bottom floor of the observation car, which does not have windows, so they were covered in gravel dust but otherwise okay. The Amtrak crew had been amazing through the whole ordeal, so it was nice to get to ride with them so I could thank them. Everyone, from the passengers to the locals to the professionals was great….even though it was super chaotic we all pitched in and helped where we could. My faith in humans was shaken in this stupid pandemic year, but it was 100% restored today. 

Lurko and I were so lucky; not only were we not hurt, but we were only 2 hours away from our destination so my brother and sister-in-law picked us up from the high school and fed us. At the time of this writing, we are with them and safe. We still have the return trip next week but we’ll cross that bridge when we come to it.